Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 1 de 1
Filter
Add more filters










Database
Language
Publication year range
1.
J Infect Dis ; 219(7): 1112-1120, 2019 03 15.
Article in English | MEDLINE | ID: mdl-30418593

ABSTRACT

BACKGROUND: In Uganda, artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DHA-PQ) showed excellent treatment efficacy for uncomplicated malaria in prior trials. Because the frequency of resistance to artemisinins and piperaquine is increasing in Southeast Asia and the prevalence of Plasmodium falciparum polymorphisms associated with resistance has changed, we reassessed treatment efficacies at 3 sites in Uganda. METHODS: For this randomized, single-blinded clinical trial, children aged 6-59 months with uncomplicated falciparum malaria were assigned treatment with AL or DHA-PQ and followed for 42 days. Primary end points were risks of recurrent parasitemia, either unadjusted or adjusted to distinguish recrudescence from new infection. We assessed selection by study regimens of relevant P. falciparum genetic polymorphisms associated with drug resistance. RESULTS: Of 599 patients enrolled, 578 completed follow-up. There were no early treatment failures. The risk of recurrent parasitemia was lower with DHA-PQ as compared to AL at all 3 sites at 42 days (26.0% vs 47.0%; P < .001). Recrudescent infections were uncommon in both the DHA-PQ and AL arms (1.1% and 2.2%, respectively; P = .25). Neither regimen selected for pfcrt or pfmdr1 polymorphisms associated with drug resistance. CONCLUSIONS: AL and DHA-PQ remain effective for the treatment of malaria in Uganda. Neither regimen selected for genetic polymorphisms associated with drug resistance. CLINICAL TRIALS REGISTRATION: ISRCTN15793046.


Subject(s)
Antimalarials/therapeutic use , Artemether, Lumefantrine Drug Combination/therapeutic use , Artemisinins/therapeutic use , Malaria, Falciparum/drug therapy , Parasitemia/drug therapy , Quinolines/therapeutic use , Antimalarials/adverse effects , Artemether, Lumefantrine Drug Combination/adverse effects , Artemisinins/adverse effects , Child, Preschool , Comparative Effectiveness Research , Drug Combinations , Drug Resistance/genetics , Female , Genotype , Humans , Infant , Male , Membrane Transport Proteins/genetics , Multidrug Resistance-Associated Proteins/genetics , Parasitemia/parasitology , Plasmodium falciparum/genetics , Protozoan Proteins/genetics , Quinolines/adverse effects , Recurrence , Single-Blind Method , Uganda
SELECTION OF CITATIONS
SEARCH DETAIL
...